I am a 62 year old man who until this week has been on no medications. A recent trip to the ER for a tick removal led to discovery of high blood pressure. I began monitoring my BP which averaged 170/96 (throwing out the high & low). A visit with my PCP (internal medicine) led to an electrocardiogram which indicated an enlarged left ventricle. I am now taking Lisinopril 10mg which has brought the high blood pressure into a safe range. I go for blood tests next week and a stress test in a couple of weeks, nothing scheduled with a cardiologist. My concern is the continuing discomfort in my chest which I can only describe as mild pain and what feels like a fast heart beat in my chest even though I have been at rest. I am normally very active and do a lot of physical labor - I own my own business. I work alone and I am afraid to go back to work for fear of getting a heart attack...am I being too cautious or should I wait for testing to be done first?

You also need to be seeing a cardio the the chest pains. Not normal to have them at all. Please get an appointment with one soon. The blood pressure is a signal of something more serious and it needs to be checked and you cannot always count on the ER to detect these things correctly. Be sure to get that appointment asap. Better to sure of what is going on. Hugs for today.

Thanks so much for the reply Rosier! I realized that the reason it appeared the Lisinopril worked so quickly was that I took one that evening and started my routine regimen the following morning, the following BP tests that day appeared to be fine. Since then the average has been considerably above normal and palpitations are frequent. After more phone calls to the PCP I am scheduled for a Holter monitor & stress test in two weeks, short of going back to the ER and requesting an echocardiogram as an inpatient I guess my options are limited. So for now I'll wait and see what happens. The lack of knowledge of what is going on is probably the worse but I'm trying not to let it get to me. Thanks for the hug!

Please do not go back to the ER. get with a cardiologist with the heart problem. It is nice that your pcp doing a stress test, but it is better to get with a heart specialist. Just get the test done and then get with a cardio to do more for your heart health. The more you get done, the more education you will get. And do go into places on the internet like American Heart Association. They have tons of information and people that can help you gai n knowledge that will go a long way. Keep hanging in there. And do not go to the ER for heart treatments except for a heart attack or some other emergency illness. That is not a good place to get heart checkups. They may tell you that it is all in your head. Good luck on the stress test and get an appointment with a cardio afterward. Hugs for today.

Please do not go to the ER for a heart monitor, that is for a cardio to do. Just go get the stress test and get a an appointment with a cardio. Please do that instead of the ER. They could just tell you that it is all in your head, which they do to people all the time. Get that appointment done after the test. Hugs for today.

I am a 62 year old man who until this week has been on no medications.

The first thing that you may find out about heart medications is that they frequently can make you feel tired or sluggish. They are designed to slow the metabolism in order to lower the blood pressure and reduce the heart rate.

Healthboards membership, by the way, has no medical professionals or students. Mostly patients and caregivers. So.... any advice you may get here, would be from members own personal experiences.

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I began monitoring my BP which averaged 170/96 (throwing out the high & low).

What was the high?

170/96 is not good.

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A visit with my PCP (internal medicine) led to an electrocardiogram which indicated an enlarged left ventricle.

EKGs can suggest an enlarged left ventricle but they are not conclusive proof.

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I am now taking Lisinopril 10mg which has brought the high blood pressure into a safe range.

Blood pressure varies all day long, usually starting lower during the earlier part of the day, and increasing as the day goes on.

For an example of how much blood pressure varies over an average 24 hour day, I created the following thread, if you would be interested in reviewing it:

I go for blood tests next week and a stress test in a couple of weeks, nothing scheduled with a cardiologist.

If it were me, I would call and ask them to call you if an earlier appointment opened up. The sooner you get to a "good" cardiologist, the better. You might check around, while you have the time, and find the best cardiologist that you can go to. There are good cardiologists and not-so-good cardiologists, just like any trade.

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My concern is the continuing discomfort in my chest which I can only describe as mild pain and what feels like a fast heart beat in my chest even though I have been at rest.

I would also be concerned.

Do you also get any shortness of breath or labored breathing? Any excessive sweating? Tiredness? Fatigue? Feel disoriented?

Do your symptoms get worse when you do physical labor?

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I am normally very active and do a lot of physical labor - I own my own business. I work alone and I am afraid to go back to work for fear of getting a heart attack...am I being too cautious or should I wait for testing to be done first?

No one here can seriously answer your question. The only way to know, for sure, is through tests, like an Echocardiogram or a Cardiac Catheterization, etc. Until you get medical help, this has to be your own judgement call.

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After more phone calls to the PCP I am scheduled for a Holter monitor & stress test in two weeks, short of going back to the ER and requesting an echocardiogram as an inpatient I guess my options are limited.

Can you get an Echocardiogram at an ER? Even if you could, the quality of that Echocardiogram might be suspect. It takes a lot of skill and training to properly do and analyse an Echocardiogram. In my case, after some very poor Echocardiogram evaluations, I finally left my Cardiologist and went to the Cleveland Clinic in search of the best I could get.

Just based on your level of concern and your symptoms, I would want to push up the schedule in any way I could. You've got two weeks to wait on the Holter and stress test. Then you've got to wait for the test results to get to your PCP and to evaluated by him.

Then you've got to get another appointment with the PCP to find out the results. If it were me, I would want to get a copy of ALL test results as soon as they were available. I would still need a medical professionals input, but I still would want to look at them. It pays to be a pro-active patient.

Then, if your PCP decides to send you to a Cardiologist, there is another wait to get into him. Then, after your Cardiologist's appointment, you've got to wait to have an Echocardiogram, or Cardiac Catheterization, and then you've got to wait for the results.

Any way of speeding things up?

In the meantime, if it were me, I would stay away from anything that could stress out my heart, like cigarette smoke, vehicle exhaust, caffeine, alcohol, excess salt in diet, large meals, coffee, tea, high calorie foods or meals, etc, and try to stay relaxed and calm.

Thank you Machaon, I wish to get to a specialist as soon as possible, there is so much I don't understand. Twice today for the first time I experienced left front shoulder pain while driving, once early this morning and more severe late this afternoon - to the point that I pulled into a rest area and took my BP which wasn't bad (149/96 HR 80). That was probably about 1 1/2 hrs ago and I feel OK now. Nothing about this makes any sense to me and the last time I saw a doctor was at the ER which was worthless. If I have similar symptoms tomorrow I'll call my PCP again (just came back from vaca. today). Will keep posting. BTW, the high was 189/106, HR 79 at rest.

... Twice today for the first time I experienced left front shoulder pain while driving, once early this morning and more severe late this afternoon ...

You have some warning symptoms that need evaluation from a Cardiologist. High blood pressure. Fast and erratic heart rate. Chest discomfort. Age: 62.

You don't have any breathing problems, or shortness of breath, or labored breathing, so that is a good sign, IMHO. I am as confused as you. I have heart failure and heart rhythm problems, am 70, and can only compare your situation to mine.

Any chance of your left front shoulder pain coming from your rotator cuff? Does it get worse if you reach across your body? How about if you reach over your head or around your back?

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- to the point that I pulled into a rest area and took my BP which wasn't bad (149/96 HR 80).

Your blood pressure is worrisome. It seems like your Diastolic is always high. That means that your circulatory system could be under unhealthy pressure ALL the time.

Do you drink coffee, tea, soda or alcohol? Do you eat chocolate? Do you eat large meals?

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Will keep posting. BTW, the high was 189/106, HR 79 at rest.

Do you know your cholesterol levels? How about your blood sugar?

Well.... you know that you have problems, what with the unhealthy blood pressure levels, the chest discomfort and the EKG showing a possibly enlarged ventricle. I would want answers as soon as I could get them.

If it turns out that you don't have coronary artery disease, or an enlarged heart and only have to go on a better diet, appropriate exercise and effective medication, then at least you will have peace of mind and a plan for getting back to better health. But, I would want to know as soon as possible the exact status of my heart and coronary system.

Thanks again for the advice. I will be receiving a heart monitor tomorrow and I am scheduled for stress test & echocardiogram on the 30th May. Doing OK right now and still able to work. I find it helpful not to get wound up over trivial matters. I'll post the test results when available.